tbuckley/cabot-search huggingface dataset:
Goals- and Burdens-based DMC as Expressions of Value Rather than Manifestations of DMC
Authors: Peter Maloy Koch
Journal: The American Journal of Bioethics (2022)

Click to increase image sizeClick to decrease image sizeThis article is referred to by:Capacities to Refuse Treatment: A ReplyThis article refers to:Three Kinds of Decision-Making Capacity for Refusing Medical Interventions Additional informationFundingThe author(s) reported there is no funding associated with the work featured in this article.
Embrace the Gray: How Tackling the Clinical Complexities of the Gray Zone Will Improve Decision-making
Authors: Alice Cavolo
Journal: The American Journal of Bioethics (2022)

Click to increase image sizeClick to decrease image sizeThis article is referred to by:Postponed Withholding: An Ethical Tool for Health Care Personnel to Empower ParentsThis article refers to:Postponed Withholding: Balanced Decision-Making at the Margins of Viability Additional informationFundingThis work was supported by a grant from Research Foundation - Flanders (FWO; Dutch: Fonds voor Wetenschappelijk Onderzoek - Vlaanderen) under Grant 1144319 N.
The upper-airway microbiome as a biomarker of asthma exacerbations despite inhaled corticosteroid treatment
Authors: Javier Perez-Garcia, Mario González-Carracedo, Antonio Espuela-Ortiz, José M. Hernández-Pérez, Ruperto González-Pérez, Olaia Sardón-Prado, Elena Martin-Gonzalez, Elena Mederos-Luis, Paloma Poza-Guedes, Paula Corcuera-Elosegui, Ariel Callero, Inmaculada Sánchez-Machín, Javier Korta-Murua, José A. Pérez-Pérez, Jesús Villar, Maria Pino-Yanes, Fabian Lorenzo-Diaz
Journal: Journal of Allergy and Clinical Immunology (2022)
Cobalt loaded electrospun poly(ε-caprolactone) grafts promote antibacterial activity and vascular regeneration in a diabetic rat model
Authors: Ziqi Huang, Yuwen Zhang, Ruihua Liu, Yi Li, Muhammad Rafique, Adam C. Midgley, Ye Wan, Hongyu Yan, Jianghua Si, Ting Wang, Cuihong Chen, Ping Wang, Muhammad Shafiq, Jia Li, Lili Zhao, Deling Kong, Kai Wang
Journal: Biomaterials (2022)
Personalised cooler dialysate for patients receiving maintenance haemodialysis (MyTEMP): a pragmatic, cluster-randomised trial
Authors: Amit X Garg, Ahmed A Al-Jaishi, Stephanie N Dixon, Jessica M Sontrop, Sierra J Anderson, Amit Bagga, Derek S Benjamin, William AD Berry, Peter G Blake, Laura C Chambers, Patricia CK Chan, Nicole F Delbrouck, Philip J Devereaux, Richard J Goluch, Laura H Gregor, Jeremy M Grimshaw, Garth J Hanson, Eduard A Illiescu, Arsh K Jain, Lauren Killin, Charmaine E Lok, Bin Luo, Reem A Mustafa, Bharat C Nathoo, Gihad E Nesrallah, Matt J Oliver, Sanjay Pandeya, Malvinder S Parmar, David N Perkins, Justin Presseau, Elijah Z Rabin, Joanna T Sasal, Tanya S Shulman, D Michael Smith, Manish Sood, Andrew W Steele, Paul YW Tam, Daniel J Tascona, Davinder B Wadehra, Ron Wald, Michael Walsh, Paul A Watson, Walter P Wodchis, Philip G Zager, Merrick Zwarenstein, Christopher W McIntyre
Journal: The Lancet (2022)
Pulmonary Arterial Hypertension Patients Have a Proinflammatory Gut Microbiome and Altered Circulating Microbial Metabolites
Authors: Daphne M. Moutsoglou, Jasmine Tatah, Sasha Z. Prisco, Kurt W. Prins, Christopher Staley, Sharon Lopez, Madelyn Blake, Levi Teigen, Felipe Kazmirczak, E. Kenneth Weir, Amanda J. Kabage, Weihua Guan, Alexander Khoruts, Thenappan Thenappan
Journal: American Journal of Respiratory and Critical Care Medicine (2022)

Inflammation drives pulmonary arterial hypertension (PAH). Gut dysbiosis causes immune dysregulation and systemic inflammation by altering circulating microbial metabolites; however, little is known about gut dysbiosis and microbial metabolites in PAH.
Atrial Functional Mitral Regurgitation
Authors: William A. Zoghbi, Robert A. Levine, Frank Flachskampf, Paul Grayburn, Linda Gillam, Jonathon Leipsic, James D. Thomas, Raymond Y. Kwong, Pieter Vandervoort, Y. Chandrashekhar
Journal: JACC. Cardiovascular imaging (2022)

Functional or secondary mitral regurgitation (MR) is associated with increased cardiovascular morbidity and mortality. Mechanistically, secondary MR is attributable to an imbalance between mitral leaflet tethering and closure forces, leading to poor coaptation. The pathophysiology of functional MR is most often the result of abnormalities in left ventricular function and remodeling, seen in ischemic or nonischemic conditions. Less commonly and more recently recognized is the scenario in which left ventricular geometry and function are preserved, the culprit being mitral annular enlargement associated with left atrial dilatation, termed atrial functional mitral regurgitation (AFMR). This most commonly occurs in the setting of chronic atrial fibrillation or heart failure with preserved ejection fraction. There is variability in the published reports and in current investigations as to the definition of AFMR. This paper reviews the pathophysiology of AFMR and focus on the need for a collective definition of AFMR to facilitate consistency in reported data and enhance much-needed research into outcomes and treatment strategies in AFMR.
Slowly Progressive Cerebellar Ataxia in a 55-Year-Old Female Patient
Authors: Mellany Tuesta Bernaola, Jacky Ganguly, Mandar Jog
Journal: JAMA Neurology (2022)

A 55-year-old female patient with a history of hypercholesterolemia and anxiety presented for imbalance, fear of falling, and progressive disability. Examination revealed gaze-evoked horizontal nystagmus, ataxic dysarthria, sensory neuronopathy, and cerebellar atrophy. What is your diagnosis?
Exercise for the Prevention of Anthracycline-Induced Functional Disability and Cardiac Dysfunction: The BREXIT Study
Authors: Stephen J. Foulkes, Erin J. Howden, Mark J. Haykowsky, Yoland Antill, Agus Salim, Sophie S. Nightingale, Sherene Loi, Piet Claus, Kristel Janssens, Amy M. Mitchell, Leah Wright, Ben T. Costello, Anniina Lindqvist, Lauren Burnham, Imogen Wallace, Robin M. Daly, Steve F. Fraser, André La Gerche
Journal: Circulation (2022)

Breast cancer survivors treated with anthracycline-based chemotherapy (AC) have increased risk of functional limitation and cardiac dysfunction. We conducted a 12-month randomized controlled trial in 104 patients with early-stage breast cancer scheduled for AC to determine whether 12 months of exercise training (ExT) could attenuate functional disability (primary end point), improve cardiorespiratory fitness (VO2peak), and prevent cardiac dysfunction.Women 40 to 75 years of age with stage I to III breast cancer scheduled for AC were randomized to 3 to 4 days per week aerobic and resistance ExT for 12 months (n=52) or usual care (UC; n=52). Functional measures were performed at baseline, at 4 weeks after AC (4 months), and at 12 months, comprising: (1) cardiopulmonary exercise testing to quantify VO2peak and functional disability (VO2peak ≤18.0 mL·kg-1·min-1); (2) cardiac reserve (response from rest to peak exercise), quantified with exercise cardiac magnetic resonance measures to determine changes in left and right ventricular ejection fraction, cardiac output, and stroke volume; (3) standard-of-care echocardiography-derived resting left ventricular ejection fraction and global longitudinal strain; and (4) biochemistry (troponin and BNP [B-type natriuretic peptide]).Among 104 participants randomized, greater study attrition was observed among UC participants (P=0.031), with 93 women assessed at 4 months (ExT, n=49; UC, n=44) and 87 women assessed at 12 months (ExT, n=49; UC, n=38). ExT attenuated functional disability at 4 months (odds ratio, 0.32 [95% CI, 0.11-0.94]; P=0.03) but not at 12 months (odds ratio, 0.27 [95% CI, 0.06-1.12]; P=0.07). In a per-protocol analysis, functional disability was prevented entirely at 12 months among participants adherent to ExT (ExT, 0% versus UC, 20%; P=0.005). Compared with UC at 12 months, ExT was associated with a net 3.5-mL·kg-1·min-1 improvement in VO2peak that coincided with greater cardiac output, stroke volume, and left and right ventricular ejection fraction reserve (P<0.001 for all). There was no effect of ExT on resting measures of left ventricular function. Postchemotherapy troponin increased less in ExT than in UC (8-fold versus 16-fold increase; P=0.002). There were no changes in BNP in either group.In women with early-stage breast cancer undergoing AC, 12 months of ExT did not attenuate functional disability, but provided large, clinically meaningful benefits on VO2peak and cardiac reserve.URL: https://www.anzctr.org.au/; Unique identifier: ACTRN12617001408370.
Is There a Real Association of Racial Disparities With In-Hospital Outcomes in Severe Bronchopulmonary Dysplasia?
Authors: Talkad S. Raghuveer, Rosey Zackula, Stephanie A. Binder
Journal: JAMA Pediatrics (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Pediatrics journal
Artificial Intelligence in Breast Cancer Screening
Authors: Kunal C. Potnis, Joseph S. Ross, Sanjay Aneja, Cary P. Gross, Ilana B. Richman
Journal: JAMA Internal Medicine (2022)

Contemporary approaches to artificial intelligence (AI) based on deep learning have generated interest in the application of AI to breast cancer screening (BCS). The US Food and Drug Administration (FDA) has approved several next-generation AI products indicated for BCS in recent years; however, questions regarding their accuracy, appropriate use, and clinical utility remain.To describe the current FDA regulatory process for AI products, summarize the evidence used to support FDA clearance and approval of AI products indicated for BCS, consider the advantages and limitations of current regulatory approaches, and suggest ways to improve the current system.Premarket notifications and other publicly available documents used for FDA clearance and approval of AI products indicated for BCS from January 1, 2017, to December 31, 2021.Nine AI products indicated for BCS for identification of suggestive lesions and mammogram triage were included. Most of the products had been cleared through the 510(k) pathway, and all clearances were based on previously collected retrospective data; 6 products used multicenter designs; 7 products used enriched data; and 4 lacked details on whether products were externally validated. Test performance measures, including sensitivity, specificity, and area under the curve, were the main outcomes reported. Most of the devices used tissue biopsy as the criterion standard for BCS accuracy evaluation. Other clinical outcome measures, including cancer stage at diagnosis and interval cancer detection, were not reported for any of the devices.The findings of this review suggest important gaps in reporting of data sources, data set type, validation approach, and clinical utility assessment. As AI-assisted reading becomes more widespread in BCS and other radiologic examinations, strengthened FDA evidentiary regulatory standards, development of postmarketing surveillance, a focus on clinically meaningful outcomes, and stakeholder engagement will be critical for ensuring the safety and efficacy of these products.
Error in Table 2 and Supplement
Journal: JAMA Network Open (2022)

Richard K. Kwok, PhD; W. Braxton Jackson II, MPH; Matthew D. Curry, MA; Patricia A. Stewart, PhD; John A. McGrath, MA; Mark Stenzel, MS; Tran B. Huynh, PhD; Caroline P. Groth, PhD; Gurumurthy Ramachandran, PhD; Sudipto Banerjee, PhD; Gregory C. Pratt, PhD; Aubrey K. Miller, MD, MPH; Xian Zhang, PhD; Lawrence S. Engel, PhD; Dale P. Sandler, PhD
Incidental Coronary Artery Calcium: Opportunistic Screening of Previous Nongated Chest Computed Tomography Scans to Improve Statin Rates (NOTIFY-1 Project)
Authors: Alexander T. Sandhu, Fatima Rodriguez, Summer Ngo, Bhavik N. Patel, Domenico Mastrodicasa, David Eng, Nishith Khandwala, Sujana Balla, Doug Sousa, David J. Maron
Journal: Circulation (2022)

Background: Coronary artery calcium (CAC) can be identified on nongated chest computed tomography (CT) scans, but this finding is not consistently incorporated into care. A deep learning algorithm enables opportunistic CAC screening of nongated chest CT scans. Our objective was to evaluate the effect of notifying clinicians and patients of incidental CAC on statin initiation. Methods: NOTIFY-1 (Incidental Coronary Calcification Quality Improvement Project) was a randomized quality improvement project in the Stanford Health Care System. Patients without known atherosclerotic cardiovascular disease or a previous statin prescription were screened for CAC on a previous nongated chest CT scan from 2014 to 2019 using a validated deep learning algorithm with radiologist confirmation. Patients with incidental CAC were randomly assigned to notification of the primary care clinician and patient versus usual care. Notification included a patient-specific image of CAC and guideline recommendations regarding statin use. The primary outcome was statin prescription within 6 months. Results: Among 2113 patients who met initial clinical inclusion criteria, CAC was identified by the algorithm in 424 patients. After chart review and additional exclusions were made, a radiologist confirmed CAC among 173 of 194 patients (89.2%) who were randomly assigned to notification or usual care. At 6 months, the statin prescription rate was 51.2% (44/86) in the notification arm versus 6.9% (6/87) with usual care ( P &lt;0.001). There was also more coronary artery disease testing in the notification arm (15.1% [13/86] versus 2.3% [2/87]; P =0.008). Conclusions: Opportunistic CAC screening of previous nongated chest CT scans followed by clinician and patient notification led to a significant increase in statin prescriptions. Further research is needed to determine whether this approach can reduce atherosclerotic cardiovascular disease events. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04789278.
A Phase 1 First-in-Human Study of FS118, a Tetravalent Bispecific Antibody Targeting LAG-3 and PD-L1 in Patients with Advanced Cancer and PD-L1 Resistance
Authors: Timothy A. Yap, Patricia M. LoRusso, Deborah J. Wong, Siwen Hu-Lieskovan, Kyriakos P. Papadopoulos, Josefin-Beate Holz, Urszula Grabowska, Cristian Gradinaru, Kin-Mei Leung, Sylwia Marshall, Claire S. Reader, Roslin Russell, Richard C.A. Sainson, Claire J. Seal, Christopher J. Shepherd, Fiona Germaschewski, Daniel Gliddon, Omer Stern, Lesley Young, Neil Brewis, Louis Kayitalire, Michelle Morrow
Journal: Clinical Cancer Research (2022)

This phase 1 study (NCT03440437) evaluated the safety, tolerability, pharmacokinetics (PK), and activity of FS118, a bispecific antibody-targeting LAG-3 and PD-L1, in patients with advanced cancer resistant to anti-PD-(L)1 therapy.Patients with solid tumors, refractory to anti-PD-(L)1-based therapy, received intravenous FS118 weekly with an accelerated dose titration design (800 μg to 0.3 mg/kg) followed by 3+3 ascending dose expansion (1 to 20 mg/kg). Primary objectives were safety, tolerability, and PK. Additional endpoints included antitumor activity, immunogenicity, and pharmacodynamics.Forty-three patients with a median of three prior regimens in the locally advanced/metastatic setting, including at least one anti-PD-(L)1 regimen, received FS118 monotherapy. FS118 was well tolerated, with no serious adverse events relating to FS118 reported. No dose-limiting toxicities (DLT) were observed, and an MTD was not reached. The recommended phase 2 dose of FS118 was established as 10 mg/kg weekly. The terminal half-life was 3.9 days. Immunogenicity was transient. Pharmacodynamic activity was prolonged throughout dosing as demonstrated by sustained elevation of soluble LAG-3 and increased peripheral effector cells. The overall disease control rate (DCR) was 46.5%; this disease control was observed as stable disease, except for one late partial response. Disease control of 54.8% was observed in patients receiving 1 mg/kg or greater who had acquired resistance to PD-(L)1-targeted therapy.FS118 was well tolerated with no DLTs observed up to and including 20 mg/kg QW. Further studies are warranted to determine clinical benefit in patients who have become refractory to anti-PD-(L)1 therapy. See related commentary by Karapetyan and Luke, p. 835.
Safety Monitoring of Bivalent COVID-19 mRNA Vaccine Booster Doses Among Persons Aged ≥12 Years — United States, August 31–October 23, 2022
Authors: Anne M. Hause, Paige Marquez, Bicheng Zhang, Tanya R. Myers, Julianne Gee, John R. Su, Phillip G. Blanc, Alisha Thomas, Deborah Thompson, Tom T. Shimabukuro, David K. Shay
Journal: MMWR Morbidity and Mortality Weekly Report (2022)

On August 31, 2022, the Food and Drug Administration (FDA) authorized bivalent formulations of BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) COVID-19 vaccines; these vaccines include mRNA encoding the spike protein from the original (ancestral) strain of SARS-CoV-2 (the virus that causes COVID-19) and from the B.1.1.529 (Omicron) variants BA.4 and BA.5 (BA.4/BA.5). These bivalent mRNA vaccines were authorized for use as a single booster dose ≥2 months after completion of primary series or monovalent booster vaccination; Pfizer-BioNTech bivalent booster was authorized for persons aged ≥12 years and Moderna for adults aged ≥18 years.*,† On September 1, 2022, the Advisory Committee on Immunization Practices (ACIP) recommended that all persons aged ≥12 years receive an age-appropriate bivalent mRNA booster dose.§ To characterize the safety of bivalent mRNA booster doses, CDC reviewed adverse events and health impacts reported after receipt of bivalent Pfizer-BioNTech and Moderna booster doses during August 31-October 23, 2022, to v-safe,¶ a voluntary smartphone-based U.S. safety surveillance system established by CDC to monitor adverse events after COVID-19 vaccination, and the Vaccine Adverse Event Reporting System (VAERS),** a U.S. passive vaccine safety surveillance system managed by CDC and FDA (1). During August 31-October 23, 2022, approximately 14.4 million persons aged ≥12 years received a bivalent Pfizer-BioNTech booster dose, and 8.2 million adults aged ≥18 years received a bivalent Moderna booster dose.†† Among the 211,959 registrants aged ≥12 years who reported receiving a bivalent booster dose to v-safe, injection site and systemic reactions were frequently reported in the week after vaccination (60.8% and 54.8%, respectively); fewer than 1% of v-safe registrants reported receiving medical care. VAERS received 5,542 reports of adverse events after bivalent booster vaccination among persons aged ≥12 years; 95.5% of reports were nonserious and 4.5% were serious events. Health care providers and patients can be reassured that adverse events reported after a bivalent booster dose are consistent with those reported after monovalent doses. Health impacts after COVID-19 vaccination are less frequent and less severe than those associated with COVID-19 illness (2).
Surgery or Endovascular Therapy for Chronic Limb-Threatening Ischemia
Authors: Alik Farber, Matthew T. Menard, Michael S. Conte, John A. Kaufman, Richard J. Powell, Niteesh K. Choudhry, Taye H. Hamza, Susan F. Assmann, Mark A. Creager, Mark J. Cziraky, Michael D. Dake, Michael R. Jaff, Diane Reid, Flora S. Siami, George Sopko, Christopher J. White, Max van Over, Michael B. Strong, Maria F. Villarreal, Michelle McKean, Ezana Azene, Amir Azarbal, Andrew Barleben, David K. Chew, Leonardo C. Clavijo, Yvan Douville, Laura Findeiss, Nitin Garg, Warren Gasper, Kristina A. Giles, Philip P. Goodney, Beau M. Hawkins, Christine R. Herman, Jeffrey A. Kalish, Matthew C. Koopmann, Igor A. Laskowski, Carlos Mena-Hurtado, Raghu Motaganahalli, Vincent L. Rowe, Andres Schanzer, Peter A. Schneider, Jeffrey J. Siracuse, Maarit Venermo, Kenneth Rosenfield
Journal: New England Journal of Medicine (2022)

Patients with chronic limb-threatening ischemia (CLTI) require revascularization to improve limb perfusion and thereby limit the risk of amputation. It is uncertain whether an initial strategy of endovascular therapy or surgical revascularization for CLTI is superior for improving limb outcomes.
Ensuring Progress Toward Racial Equity in Pulse Oximetry
Authors: Ayrenne Adams, Hyung J. Cho
Journal: JAMA Internal Medicine (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
Defibrillation after Cardiac Arrest — Is It Time to Change Practice?
Authors: Comilla Sasson, Jason Haukoos
Journal: New England Journal of Medicine (2022)

Treatment of patients in ventricular fibrillation is challenging. Despite heroic efforts, including performance of high-quality chest compressions with minimal interruptions, placement of advanced airways, multiple standard defibrillation attempts, and other interventions for advanced cardiac life support, some patients will remain in refractory ventricular fibrillation.1,2 Unfortunately, this results in a major gap in care, with emergency care personnel left with few therapeutic options, coupled with a decreasing likelihood of successful resuscitation with increasing numbers of defibrillation attempts. Recently, modified strategies for performing defibrillation in the context of refractory ventricular fibrillation have been proposed,3 including double sequential external defibrillation (DSED), in which . . .